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De Paepe AE, Garcia-Gorro C, Martinez-Horta S, Perez JP, Kulisevsky J, Rodriguez-Dechicha N, Vaquer I, Subira S, Calopa M, Santacruz P, Muñoz E, Mareca C, Ruiz-Idiago J, de Diego-Balaguer R, Camara E. Delineating apathy profiles in Huntington's disease with the short-Lille Apathy Rating Scale. Parkinsonism Relat Disord 2022; 105:83-89. [PMID: 36395542 DOI: 10.1016/j.parkreldis.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/11/2022] [Accepted: 10/23/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Apathy, a prevalent feature in neurological disorders including Huntington's disease (HD), is characterized by a reduction in goal-directed behavior across cognitive, auto-activation (i.e., self-activating thoughts/behavior), and emotional domains. Nonetheless, current diagnostic criteria are incapable of distinguishing multidimensional apathy profiles. Meanwhile, the short-Lille Apathy Rating Scale (LARS-s) bears potential as an operative diagnostic tool to disentangle apathy dimensions in clinical practice. The present study thereby examines the psychometric properties and factor structure of the LARS-s to tap into apathy profiles and their underlying neural correlates in HD. METHODS Forty HD individuals were scanned and evaluated for apathy using the LARS-s, assessed for reliability and validity in HD, and the short-Problem Behavior Assessment (PBA-s). To study the dimensional structure of apathy, principal component analysis (PCA) of the LARS-s was implemented. Resulting factors were associated with gray matter volume through whole-brain voxel-based morphometry. RESULTS The LARS-s demonstrated satisfactory psychometric properties, sharing convergent validity with PBA-s apathy and discriminant validity against depression. PCA resulted in three factors representative of apathy profiles across cognitive, auto-activation, and emotional domains. Anatomically, global apathy was significantly related with large-scale motor, cognitive, and limbic networks. Exploratory analyses of apathy profiles revealed correspondence between each factor and distinct cortical and subcortical nodes. CONCLUSION The LARS-s is capable of capturing the multidimensional spectrum of apathy. At the same time, apathy profiles in HD are underpinned by functionally diverse neural networks. Such findings promote the continued study of apathy domains to pinpoint personalized therapeutic targets in neurologic disorders in addition to HD.
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Affiliation(s)
- Audrey E De Paepe
- Cognition and Brain Plasticity Unit Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Clara Garcia-Gorro
- Cognition and Brain Plasticity Unit Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Saül Martinez-Horta
- European Huntington's Disease Network; Movement Disorders Unit, Dept of Neurology, Biomedical Research Institute Sant Pau IIB-Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Universitat Autonoma de Barcelona (U.A.B.), Medicine Department, Barcelona, Spain
| | - Jesus Perez Perez
- European Huntington's Disease Network; Movement Disorders Unit, Dept of Neurology, Biomedical Research Institute Sant Pau IIB-Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Universitat Autonoma de Barcelona (U.A.B.), Medicine Department, Barcelona, Spain
| | - Jaime Kulisevsky
- European Huntington's Disease Network; Movement Disorders Unit, Dept of Neurology, Biomedical Research Institute Sant Pau IIB-Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERNED Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain; Universitat Autonoma de Barcelona (U.A.B.), Medicine Department, Barcelona, Spain
| | | | - Irene Vaquer
- Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat Barcelona, Spain
| | - Susana Subira
- Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Matilde Calopa
- Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Pilar Santacruz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Esteban Muñoz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain; IDIBAPS Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Facultat de Medicina, University of Barcelona, Barcelona, Spain
| | - Celia Mareca
- Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Jesus Ruiz-Idiago
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain; Hospital Mare de Deu de la Mercè, Barcelona, Spain; FIDMAG Research Foundation, Barcelona, Spain
| | - Ruth de Diego-Balaguer
- Cognition and Brain Plasticity Unit Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain; ICREA Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Estela Camara
- Cognition and Brain Plasticity Unit Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain.
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Horta-Barba A, Martinez-Horta S, Perez-Perez J, Sampedro F, de Lucia N, De Michele G, Salvatore E, Kehrer S, Priller J, Migliore S, Squitieri F, Castaldo A, Mariotti C, Mañanes V, Lopez-Sendon JL, Rodriguez N, Martinez-Descals A, Júlio F, Janurio C, Delussi M, de Tommaso M, Noguera S, Ruiz-Idiago J, Sitek EJ, Wallner R, Nuzzi A, Pagonabarraga J, Kulisevsky J. Arithmetic Word-Problem Solving as Cognitive Marker of Progression in Pre-Manifest and Manifest Huntington's Disease. J Huntingtons Dis 2021; 10:459-468. [PMID: 34602494 DOI: 10.3233/jhd-210480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Arithmetic word-problem solving depends on the interaction of several cognitive processes that may be affected early in the disease in gene-mutation carriers for Huntington's disease (HD). OBJECTIVE Our goal was to examine the pattern of performance of arithmetic tasks in premanifest and manifest HD, and to examine correlations between arithmetic task performance and other neuropsychological tasks. METHODS We collected data from a multicenter cohort of 165 HD gene-mutation carriers. The sample consisted of 31 premanifest participants: 16 far-from (>12 years estimated time to diagnosis; preHD-A) and 15 close-to (≤12 years estimated time to diagnosis; preHD-B), 134 symptomatic patients (early-mild HD), and 37 healthy controls (HC). We compared performance between groups and explored the associations between arithmetic word-problem solving and neuropsychological and clinical variables. RESULTS Total arithmetic word-problem solving scores were lower in preHD-B patients than in preHD-A (p < 0.05) patients and HC (p < 0.01). Early-mild HD patients had lower scores than preHD patients (p < 0.001) and HC (p < 0.001). Compared to HC, preHD and early-mild HD participants made more errors as trial complexity increased. Moreover, arithmetic word-problem solving scores were significantly associated with measures of global cognition (p < 0.001), frontal-executive functions (p < 0.001), attention (p < 0.001) visual working memory (p < 0.001), mental rotation (p < 0.001), and confrontation naming (p < 0.05). CONCLUSION Arithmetic word-problem solving is affected early in the course of HD and is related to deficient processes in frontal-executive and mentalizing-related processes.
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Affiliation(s)
- Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain.,European Huntington's Disease Network (EHDN)
| | - Saul Martinez-Horta
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain.,European Huntington's Disease Network (EHDN)
| | - Jesús Perez-Perez
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain.,European Huntington's Disease Network (EHDN)
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Natascia de Lucia
- European Huntington's Disease Network (EHDN).,University of Naples "Federico II", Naples, Italy
| | - Giuseppe De Michele
- European Huntington's Disease Network (EHDN).,University of Naples "Federico II", Naples, Italy
| | - Elena Salvatore
- European Huntington's Disease Network (EHDN).,University of Naples "Federico II", Naples, Italy
| | - Stefanie Kehrer
- European Huntington's Disease Network (EHDN).,Department of Neuropsychiatry, Charité - Universitätsmedizin, Berlin, Germany
| | - Josef Priller
- European Huntington's Disease Network (EHDN).,Department of Neuropsychiatry, Charité - Universitätsmedizin, Berlin, Germany
| | - Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della, Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della, Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | - Anna Castaldo
- European Huntington's Disease Network (EHDN).,Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Caterina Mariotti
- European Huntington's Disease Network (EHDN).,Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Veronica Mañanes
- European Huntington's Disease Network (EHDN).,Department of Neurology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Jose Luis Lopez-Sendon
- European Huntington's Disease Network (EHDN).,Department of Neurology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Noelia Rodriguez
- European Huntington's Disease Network (EHDN).,Department of Neurology. Fundación Jimenez Diaz, Madrid, Spain
| | - Asunción Martinez-Descals
- European Huntington's Disease Network (EHDN).,Department of Neurology. Fundación Jimenez Diaz, Madrid, Spain
| | - Filipa Júlio
- European Huntington's Disease Network (EHDN).,Coimbra Institute for Biomedical Imaging and Translational Research - CIBIT, University of Coimbra, Coimbra, Portugal.,Neurology Department, Coimbra University Hospital, Coimbra, Portugal
| | - Cristina Janurio
- European Huntington's Disease Network (EHDN).,Coimbra Institute for Biomedical Imaging and Translational Research - CIBIT, University of Coimbra, Coimbra, Portugal.,Neurology Department, Coimbra University Hospital, Coimbra, Portugal
| | - Marianna Delussi
- European Huntington's Disease Network (EHDN).,Applied Neurophysiology and Pain Unit, Apulian Center for Huntington's Disease SMBNOS Department, "Aldo Moro" University, Bari, Italy
| | - Marina de Tommaso
- European Huntington's Disease Network (EHDN).,Applied Neurophysiology and Pain Unit, Apulian Center for Huntington's Disease SMBNOS Department, "Aldo Moro" University, Bari, Italy
| | - Sandra Noguera
- European Huntington's Disease Network (EHDN).,Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Jesus Ruiz-Idiago
- European Huntington's Disease Network (EHDN).,Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Emilia J Sitek
- European Huntington's Disease Network (EHDN).,Department of Neurological and Psychiatric Nursing, Faculty of Health Science, Medical University of Gdansk, Gdańsk, Poland.,Department of Neurology, St. Adalbert Hospital, Gdańsk, Poland
| | - Renata Wallner
- Department of Psychiatry, Medical University of Wroclaw, Wroclaw, Poland
| | | | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain.,European Huntington's Disease Network (EHDN)
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain.,European Huntington's Disease Network (EHDN)
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De Paepe AE, Ara A, Garcia-Gorro C, Martinez-Horta S, Perez-Perez J, Kulisevsky J, Rodriguez-Dechicha N, Vaquer I, Subira S, Calopa M, Muñoz E, Santacruz P, Ruiz-Idiago J, Mareca C, de Diego-Balaguer R, Camara E. Gray Matter Vulnerabilities Predict Longitudinal Development of Apathy in Huntington's Disease. Mov Disord 2021; 36:2162-2172. [PMID: 33998063 DOI: 10.1002/mds.28638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Apathy, a common neuropsychiatric disturbance in Huntington's disease (HD), is subserved by a complex neurobiological network. However, no study has yet employed a whole-brain approach to examine underlying regional vulnerabilities that may precipitate apathy changes over time. OBJECTIVES To identify whole-brain gray matter volume (GMV) vulnerabilities that may predict longitudinal apathy development in HD. METHODS Forty-five HD individuals (31 female) were scanned and evaluated for apathy and other neuropsychiatric features using the short-Problem Behavior Assessment for a maximum total of six longitudinal visits (including baseline). In order to identify regions where changes in GMV may describe changes in apathy, we performed longitudinal voxel-based morphometry (VBM) on those 33 participants with a magnetic resonance imaging (MRI) scan on their second visit at 18 ± 6 months follow-up (78 MRI datasets). We next employed a generalized linear mixed-effects model (N = 45) to elucidate whether initial and specific GMV may predict apathy development over time. RESULTS Utilizing longitudinal VBM, we revealed a relationship between increases in apathy and specific GMV atrophy in the right middle cingulate cortex (MCC). Furthermore, vulnerability in the right MCC volume at baseline successfully predicted the severity and progression of apathy over time. CONCLUSIONS This study highlights that individual differences in apathy in HD may be explained by variability in atrophy and initial vulnerabilities in the right MCC, a region implicated in action-initiation. These findings thus serve to facilitate the prediction of an apathetic profile, permitting targeted, time-sensitive interventions in neurodegenerative disease with potential implications in otherwise healthy populations. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Audrey E De Paepe
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Alberto Ara
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain.,Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Clara Garcia-Gorro
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Saül Martinez-Horta
- European Huntington's Disease Network, Ulm, Germany.,Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jesus Perez-Perez
- European Huntington's Disease Network, Ulm, Germany.,Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jaime Kulisevsky
- European Huntington's Disease Network, Ulm, Germany.,Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | | | - Irene Vaquer
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain
| | - Susana Subira
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain.,Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Matilde Calopa
- Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Esteban Muñoz
- European Huntington's Disease Network, Ulm, Germany.,Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.,IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain.,Facultat de Medicina, University of Barcelona, Barcelona, Spain
| | - Pilar Santacruz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Jesus Ruiz-Idiago
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Celia Mareca
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ruth de Diego-Balaguer
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain.,Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain.,European Huntington's Disease Network, Ulm, Germany.,ICREA (Catalan Institute for Research and Advanced Studies), Barcelona, Spain
| | - Estela Camara
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain.,European Huntington's Disease Network, Ulm, Germany
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Martinez-Horta S, Horta-Barba A, Perez-Perez J, Sampedro F, de Lucia N, De Michele G, Kehrer S, Priller J, Migliore S, Squitieri F, Castaldo A, Mariotti C, Mañanes V, Lopez-Sendon JL, Rodriguez N, Martinez-Descals A, Garcia-Ruiz P, Júlio F, Januário C, Delussi M, de Tommaso M, Noguera S, Ruiz-Idiago J, Sitek EJ, Nuzzi A, Pagonabarraga J, Kulisevsky J. Utility of the Parkinson's disease-Cognitive Rating Scale for the screening of global cognitive status in Huntington's disease. J Neurol 2020; 267:1527-1535. [PMID: 32030521 DOI: 10.1007/s00415-020-09730-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cognitive impairment is an essential feature of Huntington's disease (HD) and dementia is a predictable outcome in all patients. However, validated instruments to assess global cognitive performance in the field of HD are lacking. OBJECTIVES We aimed to explore the utility of the Parkinson's disease-Cognitive Rating Scale (PD-CRS) for the screening of global cognition in HD. METHODS A multicenter cohort of 132 HD patients at different disease stages and 33 matched healthy controls were classified as having preserved cognition, mild cognitive impairment (HD-MCI) or dementia (HD-Dem) according to the Clinical Dementia Rating and Functional Independence Score. The PD-CRS and the Mini-Mental State Examination were administered. Receiver operating characteristic curve analysis was used to determine optimal cutoffs to differentiate patients according to their cognitive status. RESULTS A PD-CRS cutoff score ≤ 81/82 was optimal to detect HD-MCI (sensitivity = 93%; specificity = 80%; area under the curve (AUC) = 0.940), and ≤ 63/64 was optimal to detect HD-Dem (sensitivity = 90%; specificity = 87%; AUC = 0.933). MMSE scores failed to show robust psychometric properties in this context. DISCUSSION The PD-CRS is a valid and reliable instrument to assess global cognition in HD in routine clinical care and clinical trials.
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Affiliation(s)
- Saul Martinez-Horta
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Autonomous University of Barcelona, Barcelona, Spain.,European Huntington's Disease Network (EHDN), Ulm, Germany
| | - Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,European Huntington's Disease Network (EHDN), Ulm, Germany
| | - Jesús Perez-Perez
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Autonomous University of Barcelona, Barcelona, Spain.,European Huntington's Disease Network (EHDN), Ulm, Germany
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Autonomous University of Barcelona, Barcelona, Spain
| | - Natascia de Lucia
- European Huntington's Disease Network (EHDN), Ulm, Germany.,University of Naples "Federico II", Naples, Italy
| | - Giuseppe De Michele
- European Huntington's Disease Network (EHDN), Ulm, Germany.,University of Naples "Federico II", Naples, Italy
| | - Stefanie Kehrer
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neuropsychiatry, Charité, Universitätsmedizin, Berlin, Germany
| | - Josef Priller
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neuropsychiatry, Charité, Universitätsmedizin, Berlin, Germany
| | - Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | - Anna Castaldo
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Caterina Mariotti
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Veronica Mañanes
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neurology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Jose Luis Lopez-Sendon
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neurology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Noelia Rodriguez
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neurology, Fundación Jimenez Diaz, Madrid, Spain
| | - Asunción Martinez-Descals
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neurology, Fundación Jimenez Diaz, Madrid, Spain
| | - Pedro Garcia-Ruiz
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neurology, Fundación Jimenez Diaz, Madrid, Spain
| | - Filipa Júlio
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Neurology Department, Coimbra University Hospital, Coimbra, Portugal.,Coimbra Institute for Biomedical Imaging and Translational Research - CIBIT, University of Coimbra, Coimbra, Portugal
| | - Cristina Januário
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Neurology Department, Coimbra University Hospital, Coimbra, Portugal.,Coimbra Institute for Biomedical Imaging and Translational Research - CIBIT, University of Coimbra, Coimbra, Portugal
| | - Marianna Delussi
- European Huntington's Disease Network (EHDN), Ulm, Germany.,SMBNOS Department, Bari Aldo Moro University, Bari, Italy
| | - Marina de Tommaso
- European Huntington's Disease Network (EHDN), Ulm, Germany.,SMBNOS Department, Bari Aldo Moro University, Bari, Italy
| | - Sandra Noguera
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Jesus Ruiz-Idiago
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Hospital Mare de Deu de la Mercè, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Emilia J Sitek
- European Huntington's Disease Network (EHDN), Ulm, Germany.,Department of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdańsk, Poland.,Department of Neurology, St. Adalbert Hospital, Copernicus, PL, Gdańsk, Poland
| | - Angela Nuzzi
- European Huntington's Disease Network (EHDN), Ulm, Germany
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain.,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Autonomous University of Barcelona, Barcelona, Spain.,European Huntington's Disease Network (EHDN), Ulm, Germany
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain. .,Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain. .,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain. .,Autonomous University of Barcelona, Barcelona, Spain. .,European Huntington's Disease Network (EHDN), Ulm, Germany.
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De Paepe AE, Sierpowska J, Garcia-Gorro C, Martinez-Horta S, Perez-Perez J, Kulisevsky J, Rodriguez-Dechicha N, Vaquer I, Subira S, Calopa M, Muñoz E, Santacruz P, Ruiz-Idiago J, Mareca C, de Diego-Balaguer R, Camara E. White matter cortico-striatal tracts predict apathy subtypes in Huntington's disease. Neuroimage Clin 2019; 24:101965. [PMID: 31401404 PMCID: PMC6700450 DOI: 10.1016/j.nicl.2019.101965] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/23/2019] [Accepted: 07/28/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Apathy is the neuropsychiatric syndrome that correlates most highly with Huntington's disease progression, and, like early patterns of neurodegeneration, is associated with lesions to cortico-striatal connections. However, due to its multidimensional nature and elusive etiology, treatment options are limited. OBJECTIVES To disentangle underlying white matter microstructural correlates across the apathy spectrum in Huntington's disease. METHODS Forty-six Huntington's disease individuals (premanifest (N = 22) and manifest (N = 24)) and 35 healthy controls were scanned at 3-tesla and underwent apathy evaluation using the short-Problem Behavior Assessment and short-Lille Apathy Rating Scale, with the latter being characterized into three apathy domains, namely emotional, cognitive, and auto-activation deficit. Diffusion tensor imaging was used to study whether individual differences in specific cortico-striatal tracts predicted global apathy and its subdomains. RESULTS We elucidate that apathy profiles may develop along differential timelines, with the auto-activation deficit domain manifesting prior to motor onset. Furthermore, diffusion tensor imaging revealed that inter-individual variability in the disruption of discrete cortico-striatal tracts might explain the heterogeneous severity of apathy profiles. Specifically, higher levels of auto-activation deficit symptoms significantly correlated with increased mean diffusivity in the right uncinate fasciculus. Conversely, those with severe cognitive apathy demonstrated increased mean diffusivity in the right frontostriatal tract and left dorsolateral prefrontal cortex to caudate nucleus tract. CONCLUSIONS The current study provides evidence that white matter correlates associated with emotional, cognitive, and auto-activation subtypes may elucidate the heterogeneous nature of apathy in Huntington's disease, as such opening a door for individualized pharmacological management of apathy as a multidimensional syndrome in other neurodegenerative disorders.
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Affiliation(s)
- Audrey E De Paepe
- Department of Neuroscience, Pomona College, Claremont, CA, United States; Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joanna Sierpowska
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Medical Psychology, Nijmegen, The Netherlands
| | - Clara Garcia-Gorro
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Saül Martinez-Horta
- European Huntington's Disease Network, Germany; Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jesus Perez-Perez
- European Huntington's Disease Network, Germany; Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jaime Kulisevsky
- European Huntington's Disease Network, Germany; Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | | | - Irene Vaquer
- Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain
| | - Susana Subira
- Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Matilde Calopa
- Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Esteban Muñoz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain; IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain; Facultat de Medicina, University of Barcelona, Barcelona, Spain
| | - Pilar Santacruz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Jesus Ruiz-Idiago
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain; Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Celia Mareca
- Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Ruth de Diego-Balaguer
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain; ICREA (Catalan Institute for Research and Advanced Studies), Barcelona, Spain
| | - Estela Camara
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain.
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6
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Garcia-Gorro C, Llera A, Martinez-Horta S, Perez-Perez J, Kulisevsky J, Rodriguez-Dechicha N, Vaquer I, Subira S, Calopa M, Muñoz E, Santacruz P, Ruiz-Idiago J, Mareca C, Beckmann CF, de Diego-Balaguer R, Camara E. Specific patterns of brain alterations underlie distinct clinical profiles in Huntington's disease. Neuroimage Clin 2019; 23:101900. [PMID: 31255947 PMCID: PMC6606833 DOI: 10.1016/j.nicl.2019.101900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/16/2022]
Abstract
Huntington's disease (HD) is a genetic neurodegenerative disease which involves a triad of motor, cognitive and psychiatric disturbances. However, there is great variability in the prominence of each type of symptom across individuals. The neurobiological basis of such variability remains poorly understood but would be crucial for better tailored treatments. Multivariate multimodal neuroimaging approaches have been successful in disentangling these profiles in other disorders. Thus we applied for the first time such approach to HD. We studied the relationship between HD symptom domains and multimodal measures sensitive to grey and white matter structural alterations. Forty-three HD gene carriers (23 manifest and 20 premanifest individuals) were scanned and underwent behavioural assessments evaluating motor, cognitive and psychiatric domains. We conducted a multimodal analysis integrating different structural neuroimaging modalities measuring grey matter volume, cortical thickness and white matter diffusion indices - fractional anisotropy and radial diffusivity. All neuroimaging measures were entered into a linked independent component analysis in order to obtain multimodal components reflecting common inter-subject variation across imaging modalities. The relationship between multimodal neuroimaging independent components and behavioural measures was analysed using multiple linear regression. We found that cognitive and motor symptoms shared a common neurobiological basis, whereas the psychiatric domain presented a differentiated neural signature. Behavioural measures of different symptom domains correlated with different neuroimaging components, both the brain regions involved and the neuroimaging modalities most prominently associated with each type of symptom showing differences. More severe cognitive and motor signs together were associated with a multimodal component consisting in a pattern of reduced grey matter, cortical thickness and white matter integrity in cognitive and motor related networks. In contrast, depressive symptoms were associated with a component mainly characterised by reduced cortical thickness pattern in limbic and paralimbic regions. In conclusion, using a multivariate multimodal approach we were able to disentangle the neurobiological substrates of two distinct symptom profiles in HD: one characterised by cognitive and motor features dissociated from a psychiatric profile. These results open a new view on a disease classically considered as a uniform entity and initiates a new avenue for further research considering these qualitative individual differences.
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Affiliation(s)
- Clara Garcia-Gorro
- Cognition and Brain Plasticity Unit, L'Hospitalet de Llobregat (Barcelona), IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), Spain
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Alberto Llera
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
| | - Saul Martinez-Horta
- Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jesus Perez-Perez
- Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | - Irene Vaquer
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de Llobregat (Barcelona), Spain
| | - Susana Subira
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de Llobregat (Barcelona), Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Matilde Calopa
- Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Esteban Muñoz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
- IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
- Facultat de Medicina, University of Barcelona, Barcelona, Spain
| | - Pilar Santacruz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Jesus Ruiz-Idiago
- Hospital Mare de Deu de la Mercè, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Celia Mareca
- Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Christian F. Beckmann
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ruth de Diego-Balaguer
- Cognition and Brain Plasticity Unit, L'Hospitalet de Llobregat (Barcelona), IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), Spain
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
- The Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- ICREA (Catalan Institute for Research and Advanced Studies), Barcelona, Spain
| | - Estela Camara
- Cognition and Brain Plasticity Unit, L'Hospitalet de Llobregat (Barcelona), IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), Spain
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7
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Garcia-Gorro C, Garau-Rolandi M, Escrichs A, Rodriguez-Dechicha N, Vaquer I, Subira S, Calopa M, Martinez-Horta S, Perez-Perez J, Kulisevsky J, Muñoz E, Santacruz P, Ruiz-Idiago J, Mareca C, de Diego-Balaguer R, Camara E. An active cognitive lifestyle as a potential neuroprotective factor in Huntington's disease. Neuropsychologia 2018; 122:116-124. [PMID: 30563619 DOI: 10.1016/j.neuropsychologia.2018.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 10/16/2018] [Accepted: 10/20/2018] [Indexed: 01/21/2023]
Abstract
A cognitive stimulating lifestyle has been observed to confer cognitive benefits in multiple neurodegenerative diseases. However, the underlying neurobiological basis of this phenomenon remains unclear. Huntington's disease can provide a suitable model to study the effects and neural mechanisms of cognitive engagement in neurodegeneration. In this study, we investigate the effect of lifestyle factors such as education, occupation and engagement in cognitive activities in Huntington's disease gene carriers on cognitive performance and age of onset as well as the underlying neural changes sustaining these effects, measured by magnetic resonance imaging. Specifically, we analyzed both gray matter volume and the strength of connectivity of the executive control resting-state network. High levels of cognitive engagement were significantly associated with more preserved executive functions, a delay in the appearance of symptoms, reduced volume loss of the left precuneus and the bilateral caudate and a modulation of connectivity strength of anterior cingulate cortex and left angular gyrus with the executive control network. These findings suggest that a cognitively stimulating lifestyle may promote brain maintenance by modulating the executive control resting-state network and conferring protection against neurodegeneration, which results in a delayed onset of symptoms and improved performance in executive functions.
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Affiliation(s)
- Clara Garcia-Gorro
- Cognition and Brain Plasticity Unit, Neuroscience Program, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Maria Garau-Rolandi
- Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain
| | - Anira Escrichs
- Cognition and Brain Plasticity Unit, Neuroscience Program, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Irene Vaquer
- Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain
| | - Susana Subira
- Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Matilde Calopa
- Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Saul Martinez-Horta
- Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jesus Perez-Perez
- Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Department of Neurology, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain; Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Esteban Muñoz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain; IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain; Facultat de Medicina, University of Barcelona, Barcelona, Spain
| | - Pilar Santacruz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | | | - Celia Mareca
- Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Ruth de Diego-Balaguer
- Cognition and Brain Plasticity Unit, Neuroscience Program, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain; The Institute of Neurosciences, University of Barcelona, Barcelona, Spain; ICREA (Catalan Institute for Research and Advanced Studies), Barcelona, Spain
| | - Estela Camara
- Cognition and Brain Plasticity Unit, Neuroscience Program, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Barcelona, Spain.
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8
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Martinez-Horta S, Perez-Perez J, van Duijn E, Fernandez-Bobadilla R, Carceller M, Pagonabarraga J, Pascual-Sedano B, Campolongo A, Ruiz-Idiago J, Sampedro F, Landwehrmeyer GB, Kulisevsky J. Corrigendum to "Neuropsychiatric symptoms are very common in premanifest and early stage Huntington's disease" [Parkinsonism Relat. Disord. 25C (2016) 58-64]. Parkinsonism Relat Disord 2016; 31:161. [PMID: 27567724 DOI: 10.1016/j.parkreldis.2016.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Saul Martinez-Horta
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Centro Investigaci_on Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Jesus Perez-Perez
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Centro Investigaci_on Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Erik van Duijn
- Department of Psychiatry, Leiden University Medical Centre, Leiden, and Centre for Mental Health Care Delfland, Delft, The Netherlands
| | - Ramon Fernandez-Bobadilla
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Centro Investigaci_on Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Mar Carceller
- Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain
| | - Javier Pagonabarraga
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Centro Investigaci_on Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Berta Pascual-Sedano
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Centro Investigaci_on Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Antonia Campolongo
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Centro Investigaci_on Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | | | | | | | | | - Jaime Kulisevsky
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Aut_onoma de Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Centro Investigaci_on Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Universitat Oberta de Catalunya (UOC), Barcelona, Spain.
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